Efforts to repeal the Affordable Care Act came to a grinding halt earlier this week when it was made apparent that there were insufficient votes in the Senate to pass the Graham-Cassidy proposal. Under reconciliation rules, Senate Majority Leader Mitch McConnell had until the end of September to pass a repeal bill with a simple majority vote. Now it seems that the Senate, U.S. House, and administration are ready to move on from efforts to repeal and replace the Affordable Care Act (at least for the immediate future) and focus their attention on another top priority—reforming the tax code.
However, much can be done without legislative authority to undermine the Affordable Care Act. For example, the administration significantly cut the amount of funding that supports organizations, referred to as navigators, that assist individuals in enrolling in marketplaces. Last year, navigators received $62.5 million; this year $36.8 million will be made available. In addition, funding for advertisements spent during the open enrollment period was slashed by 90 percent, and the open enrollment period was shortened from three months to 45 days.
Most importantly, instability in the individual market is driving up health care premiums in some states. Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) will resume their bipartisan efforts to shore up the individual market, which was underway before momentum for the Graham-Cassidy proposal picked up. Efforts are back on the table to come up with a compromise bill that focuses on stabilizing the individual market for the next two years.
Medicaid will continue to be a target for the foreseeable future; the Alliance Public Policy Office will be monitoring congressional efforts that lead to significant changes in the Medicaid program.
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